Worship After Pregnancy Loss

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Worship After Pregnancy Loss?

Marilyn Washburn, M.D., M. Div.

Grady Hospital Clinic, Atlanta, Georgia

Worship at the occasion of a pregnancy loss? . . . On first consideration, the idea sounds unusual, if not frankly strange. We tend to think of these unhappy events as infrequent and very private. Furthermore, the church has never had a special liturgical rite for this sort of situation. Yet, many parents are beginning to ask for some service of closure and some opportunity to celebrate the brief life that has been shared with an unborn child. This paper examines some of the factors that are contributing to this change, and some of the pastoral issues involved in planning a service of worship for these families. This is an area in which modern medical technology has made a tremendous impact on family life. Today, it is not at all uncommon for parents to know they are expecting within a few days of conception; fathers carry ultrasonographic “pictures” of their six-week-gestation progeny in their wallets, to be shown proudly to family and friends; the sex of the baby may be determined with certainty before the mother “begins to show”; and parents may watch fetal responses to the mother’s voice and activity even before she can feel fetal movement. In short, the bonding process, that series of interactions through which we humans come to know one another, may begin much earlier in pregnancy than ever before in human history. These dramatic and yet commonplace developments, and today’s drastically reduced childhood mortality give the impression that prenatal and infant death are relatively rare. Couples think of themselves as parents; they become deeply emotionally invested; and, instead of “experiencing a pregnancy” or even “expecting a baby,” they often understand themselves to be “having a child.” Unfortunately, the common perception is illusory. Far from being an infrequent event, perhaps as many as one fourth of all pregnancies end in death before birth. These deaths can be very lonely times for the bereaved parents. The number of family members and friends who even know about their loss may be very small, especially if the pregnancy was very brief. And many people will presume that the primary crisis is the mother’s illness, rather than a death. The family is usually separated, with the mother hospitalized, the father in a surgical waiting area down the hall from a hospital nursery, and older siblings quickly “farmed out” to frightened and grieving grandparents or friends. The parents may not have an opportunity to see their child, or may be required to make several important decisions very quickly. Often, mothers are discharged within a few hours, precluding a visit by the hospital chaplain and making it difficult to establish relationships with nurses or social workers that may be extremely helpful in the future. Parents often feel betrayed—by God, by their health care providers, by friends who do not understand, by their own bodies. In these lonely and painful circumstances, the opportunity to worship is an opportunity to challenge God for answers, to forgive and be forgiven, to share

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one’s grief with others, to remember and celebrate special moments, and to hear a word of hope. Why, then, are we pastors so uncomfortable in offering to arrange worship services for these occasions? Why is there so very little in our pastoral literature and training to guide us in caring for these families? The answers to these questions are multiple and complex; examining a few of them is important to understanding and overcoming our reluctance to offer this opportunity for healing. Some of the contributing factors are historical. Until the modern era, pregnancy loss was not considered to be within the purview of male-dominated ecclesiastical or medical domains. Instead, it was perceived as “something that happens to women,” and the crisis was managed at home by other women. There is also some historical evidence that parents of past eras were discouraged from becoming “attached” to newborns and even young children, in an effort to spare them the pain of repeated grief when infant/child mortality was very high. Perhaps the most significant reason is the sacramental theology of the pre-Reformation church, in which the urgent concern was to baptize the child. The concern for the child’s salvation overshadowed the parents’ loss; and the assurance afforded by baptism represented an important act of pastoral care that was not replaced when “emergency baptism” and “conditional baptism ” were abandoned by the Reformers. There are also contemporary sociological factors that contribute to our discomfort when contemplating worship with families in these crises. Most of us have been taught to encourage mourners to talk about their loved one’s death, to rehearse the terminal events in order to grasp the reality of the loss. But in this situation that often means talking about the mother’s sexual anatomy and physiology as well. Even when we and our parishioners can bring ourselves to the point of having this intimate sort of sharing, the story often contains very little that can be incorporated comfortably into a funeral homily. The personal allusions and anecdotes we usually include to individualize a funeral service could cause a great deal of discomfort to parents in this setting. A second important factor is that pregnancy loss affects pastors, too, and our opportunities for supportive care are as limited as those of parishioners. Offering to “go through” this experience with grieving families frequently means we must deal with our own unresolved grief, and these services can then become very costly in terms of time and emotional energy. Finally, the debate about the personhood of the fetus is in the forefront of pressing ethical issues from many mainline denominations; developing a liturgical rite to celebrate the death of the unborn may imply a theology that is in conflict with the theology underlying our ethics of abortion. Some of these factors remain important considerations; others, as we have noted, have been reduced in importance by technological and historical developments . How can a pastor know when to suggest that a service of worship would be helpful? How can such services be arranged, and what should such a service include? It is very helpful to insure that the opportunity for worship in these situations exists before a crisis occurs. A simple inquiry into hospital policies and

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procedures regarding length of hospitalization, disposal of the baby’s body, etc., may save a great deal of frenzied questioning and patchwork care in the future. There is a growing body of lay literature on the subject of pregnancy loss that is an excellent source of suggestions for creating these opportunities where they do not already exist. It is also helpful to begin collecting liturgical resources long in advance of such crises, freeing time for pastoral visitation when they do occur. One of the most difficult issues is the question of baptism. Several authors, (Case and Moody, among others), have recommended or described baptismal rites for stillborn children; but this presents awkward difficulties for Protestant pastors. Of course, this is not the time for a short course in sacramental theology ; yet, a simple refusal seems to add to the hurt of bereaved parents, and may cut off further sharing and opportunity for support. Rather than tell parents that their request is inappropriate, the pastor can invite them to share what they would like to include in a baptismal service. In my experience, Protestant parents have inevitably said that they wanted to give their child a name. For them, baptism represents a way of affirming the importance of their child’s brief life; and of expressing their love by sharing something that is intimately theirs. Explaining this, as painful as it often is, helps them to understand and articulate their wishes and needs. Then a simple explanation will usually enable them see the difference between their request and what baptism offers:

You know, baptism doesn’t give a child a name; it’s really a sign and promise of life in Christ . . . and your child is already experiencing that far more fully than you and I can imagine. It seems to me that what we really need to do is give the baby a name and celebrate how very important she/he is to us.

Some parent-support groups have experienced this naming to be so helpful that they recommend names be given regardless of how prematurely the child was born. If it is not possible to determine the sex of the baby, names like Kim, Chris, or Robyn may be used. A name is sometimes the only gift a family has the opportunity to give such a child, and it offers them an alternative to the dilemma of referring to “The Baby,” even after other babies arrive. A second frequent concern is the question of who should be included in such a service. The answer, of course will depend on the individual circumstances , and there can be no substitute for doing one’s “pastoral homework.” But, some guidelines are worth considering. First, remember that this is the father’s loss as well as the mother’s; many people will perceive this family crisis as maternal illness, and expect the bereaved father to be his wife’s support. A worship service of this sort may represent his only opportunity to grieve in a supportive community. Secondly, the siblings of the baby should at least be considered. Their presence may comfort parents, and may make the celebration of a child’s life and death much more childlike. When they are to be included , it is important to design the liturgy with great care, so that they have opportunities to participate, and their conceptualizations of death are not distorted . Grandparents, too, are often forgotten at these times; but they may have compound losses, as they agonize for their children, grieve for grandchil-

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dren, and perhaps relive their own losses. These occasions often have the potential for healing strained relationships between parents and adult children who share such a loss. Finally, it may be appropriate to include friends and hospital personnel, especially when there have been multiple or prolonged crises in a pregnancy. A service of this sort will probably be briefer and less formal than most funerals. But in many other respects it will be very similar, including prayers of gratitude and intercession, scriptural assurances, a sermon of comfort and hope, and perhaps a children’s hymn. In addition to naming the baby, there are two aspects of these worship events that can be very special. The first is the inclusion of a confession of sin and assurance of pardon. Pastorally, this may be a very delicate issue since most parents experience a great deal of guilt following the death of a child. Only rarely can a pregnancy loss be directly attributed to the mother’s neglect, and great care must be taken not to reinforce her fears that she somehow caused her baby’s death. At the same time, this may be an occasion when the profound theological meaning of “sin” is very real; it is painfully clear that God’s good creation is broken and marred, and that even our most heroic human efforts cannot heal it. One mother described her own needs:

I know that I did everything I could to save my daughter’s life; and knowing that gives me some comfort. But, I’m not just my will . . . I’m my body, too. And that part of me didn’t do enough. I appreciate my doctor’s reassurances that I’m not guilty . . . that she knows I did all I could. But I also need forgiveness.

There is also usually a great need to forgive one another; to lay down the blame that may be felt towards one’s spouse, towards health care providers, and especially towards one’s self. Since the death of a baby before birth is a very physical loss, and those who worship together will be close family and intimate friends, the ritual of “passing the peace” may be of special significance in this setting. It offers the opportunity to greet and physically embrace others in the context of worship; to give words of consolation as well as receive them; and to proclaim the promise of peace and healing. Thus, it offers an opportunity to “act out” forgiveness and acceptance of one another. The liturgical resources available to pastors are very meager. Most liturgies for the funerals of children can be adapted with a little imagination and careful listening to grieving parents. Language borrowed from the baptismal liturgy may enrich worship by its connotations, as well as its symbolism. The poetry of Marion Cohen, found in Mothering Magazine, give poignant and moving expression to the anguish of bereaved parents. The “chaplains” of local chapters of parent-support organizations (such as AMEND and SHARE) often have liturgical resources written for similar occasions. As these organizations and the lay press continue to encourage families to have these services of worship , the need to network these resources will grow. The death of a child before birth is a crisis of unrealized magnitude; it remains a frequent family crisis in modern life. As in any such crisis, worship offers the opportunity for forgiveness and reordering one’s life, for comfort,

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and for receiving the Word of hope. And so it is a critically important act of pastoral care.

BIBLIOGRAPHY

Berezin, Nancy, After A Loss In Pregnancy. New York: Simon and Schuster, 1982. Borg, Susan and Judith Lasker, When Pregnancy Fails. Boston: Beacon Press, 1981. This book includes a chapter specifically for clergy. Case, Ronna, “When Birth Is Also A Funeral,” Journal of Pastoral Care 32, 1; 6-21. Cohen, Marion, “This is What I Do With Kerin,” Mothering (Fall 1980); 89-93. St. John’s Hospital, Starting Your Own Share Group. St. John’s Hospital, Springfield, Illinois.